Middle cerebral artery infarction: relationship of cavernous carotid artery calcification

Abstract

Background and purpose: This study was designed to determine whether calcification of the cavernous carotid artery (CCA) is associated with cerebrovascular infarcts in the same way that coronary artery calcification scores indicate myocardial infarctions. We sought to correlate the grade of CCA calcification with infarctions in the middle cerebral artery (MCA) distribution.

Methods: Nonenhanced brain CT scans of 40 patients with MCA-distribution strokes, 34 with non-MCA-distribution strokes, and 94 age-matched control subjects were reviewed. Circumferential calcification and thickness of calcification were graded for the CCAs on head CT scans. Scores were determined for the left and right CCAs. Mann-Whitney tests and Spearman correlation coefficients were used to detect differences between patients and control subjects and between patients with MCA and those with non-MCA strokes.

Results: CCA calcification scores did not significantly differ in the groups compared. The manner in which calcification was scored (by using circumference, thickness, or both) did not affect the results. No difference was noted between scores ipsilateral and those contralateral to the stroke.

Conclusion: Circumferential degree or thickness of cavernous artery calcification was not correlated with MCA or non-MCA infarctions. CCA calcification scores did not differ between patients with stroke and those without stroke.

Figures

Fig 1.

Scoring system. A, Grade 1. Small dot of calcification 1 mm thick is present in the left CCA wall. Grades for this plaque are 1 for extent and 1 for thickness. B, Grade 2. CT scan of the right CCA shows an atherosclerotic, calcified plaque that is crescentic but <90° of the vascular circumference. Grades are 2 for extent and 1 (1 mm) for thickness. C, Grade 3. Circumferential involvement of the right CCA calcification is 90° but <270°; therefore, the grade is 3 for extent. D, Grade 4. Both carotid arteries show complete circumferential involvement with atherosclerotic plaque, hence grade 4.